Nokea
A client at 32 weeks' gestation is diagnosed with oligohydramnios. What complication is associated with this condition?
- A. Fetal macrosomia.
- B. Cord prolapse.
- C. Pulmonary hypoplasia.
- D. Placenta previa.
Correct Answer: C
Rationale: Oligohydramnios can lead to pulmonary hypoplasia due to insufficient amniotic fluid for lung development.
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A nurse is planning care for a newborn who has neonatal abstinence syndrome. Which of the following interventions should the nurse include in the plan of care?
- A. Increase the newborn's visual stimulation
- B. Weigh the newborn every other day
- C. Discourage parental interaction until after a social evaluation
- D. Swaddle the newborn in a flexed position
Correct Answer: D
Rationale: Neonatal abstinence syndrome (NAS) occurs in newborns who were exposed to addictive drugs in utero, commonly seen in infants born to mothers with substance use disorders. These babies often experience withdrawal symptoms such as tremors, irritability, and difficulty sleeping. Swaddling the newborn in a flexed position can help provide comfort and security to the infant, which may help alleviate some of the withdrawal symptoms they are experiencing. This intervention can also mimic the snug environment of the womb, promoting a sense of calmness for the newborn. It is important to create a soothing environment to aid in the management of NAS symptoms.
The nurse is caring for a client with gestational diabetes. What complication should the nurse monitor for during labor?
- A. Placental abruption.
- B. Macrosomia.
- C. Preterm labor.
- D. Postpartum hemorrhage.
Correct Answer: B
Rationale: Macrosomia is a common complication of gestational diabetes, increasing the risk of delivery challenges.
What is the priority nursing action when shoulder dystocia is encountered during delivery?
- A. Apply fundal pressure
- B. Call for additional assistance
- C. Perform the McRoberts maneuver
- D. Encourage the mother to push harder
Correct Answer: C
Rationale: The McRoberts maneuver widens the pelvic outlet for delivery.
Which intervention is most critical for a mother with a uterine atony postpartum?
- A. Perform uterine massage
- B. Administer oxytocin infusion
- C. Monitor blood pressure and pulse frequently
- D. Encourage breastfeeding to stimulate uterine contractions
Correct Answer: A
Rationale: Performing uterine massage helps contract the uterus and reduce bleeding in uterine atony.
The nurse is caring for a client whose labor is being augmented with Pitocin. He or she recognizes that Pitocin should be stopped immediately if there is evidence of what?
- A. Fetal HR 180 without sense of variability
- B. Rupture of amniotic membrane
- C. Client needs to void
- D. Uterine contractions q8-10 minutes
Correct Answer: A
Rationale: Pitocin is a medication commonly used to induce or augment labor by stimulating uterine contractions. It is critical for the nurse to monitor the client closely for potential adverse effects. Fetal distress is a serious concern when Pitocin is being administered. A fetal heart rate of 180 beats per minute without variability may indicate fetal distress due to uteroplacental insufficiency. This is a sign of fetal hypoxia and warrants immediate intervention, including stopping the infusion of Pitocin, repositioning the mother, administering oxygen, and notifying the healthcare provider. It is crucial for the nurse to act promptly to ensure the safety and well-being of both the fetus and the mother.